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Finding and Treating Fetal Heart Defects

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Duke Health News 919-660-1306

DURHAM, N.C. -- Doctors with Duke University Medical Center's
Fetal Cardiology Program can accurately diagnose heart defects
before birth with fetal echocardiograpy, a test similar to the
ultrasound performed in an obstetrician's office.

"We believe the best care of a child with suspected or known
congenital heart disease begins before the child is born," said
Piers Barker, M.D. assistant professor of pediatric cardiology
at Duke.

About 40,000 babies in the U.S. are born with heart defects
each year, according to the March of Dimes. Heart defects are
among the most common birth defects and are the leading cause
of birth defect-related deaths, the organization says.

A fetal echocardiogram is similar to an obstetrical
ultrasound; both use sound waves to create an image of the
fetus. However, fetal echocardiography ultrasound is designed
to clearly capture pictures of a tiny, fast beating fetal
heart. It is painless and non-invasive.

Early diagnosis of congenital heart defects is important
because it allows parents and physicians time to prepare for
care after the baby is born, Barker said. In most cases,
expectant mothers can continue to see their regular
obstetrician, he said. "However, if a fetus has complex
congenital heart disease, we often recommend the mother deliver
at a tertiary care hospital with immediate access to a level
III NICU and pediatric cardiothoracic surgeons," Barker said. A
NICU is a neonatal intensive care unit.

At Duke, expectant parents may tour the labor and delivery
areas, the NICU, the pediatric cardiac intensive care unit and
meet with a surgeon if their child has a heart condition that
will require surgery a few days after birth. And for families
from rural areas, early diagnosis and planning for birth at a
major hospital can prevent disruptions and unnecessary
separation

"Fetal echocardiography really allows families to be more
prepared, especially people from rural areas," said Stephen
Miller, M.D., a pediatric cardiologist who oversees the Duke
Children's cardiology program in Fayetteville, N.C.

With advances in surgical treatment, many children now
undergo surgery to repair congenital heart defects before they
are one year old. This early care can help prevent the
development of additional complications and gives children an
earlier start on a normal life, Barker said.

Doctors may recommend fetal echocardiography for pregnant
women with a family history of congenital heart defects or
known or suspected genetic syndromes. Other common reasons
include maternal diabetes or diseases such as lupus and
scleroderma, exposure to certain medications and irregular
fetal heart rhythms. In the case of fetal arrthymia – when the
heart beats too fast or too slow – doctors can treat the mother
with medication to indirectly treat the fetus.

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